What You Should Know:
- Despite investment in digital health tools, health plan member usage remains low, according to the J.D. Power 2023 U.S. Commercial Member Health Plan Study. The J.D. study reveals digital health usage for all tools and support remains below 50%.
- Even among the sickest patients, use of online health assessments is 18%; use of chronic disease management tools is 8%; use of online triage and nursing support is 10%; and remote monitoring 6%.
U.S. Commercial Member Health Plan Study Background
The U.S. Commercial Member Health Plan Study measures satisfaction among members of 147 health plans in 22 regions throughout the United States by examining six factors (in alphabetical order): billing and payment; cost; coverage and benefits; customer service; information and communication; and provider choice. The study is based on responses from 32,656 commercial health plan members and was fielded from January through April 2023.
The study finds customer satisfaction with commercial health plans is particularly strained among members of Gen Y1 and Gen Z, driven largely by poor customer service and communication scores. Similarly, members with the lowest self-reported health status are most likely to experience communications challenges with their health plans.
Other key findings of the 2023 study include:
- Overall satisfaction declines year over year: Overall satisfaction falls 13 points (on a 1,000-point scale) this year, driven largely by a 33-point decline in satisfaction with customer service. Coverage and benefits (-20 points); provider choice (-16); and information and communication (-16) also decline significantly.
- Net Promoter Score®2 for new members is poor, highlighting importance of onboarding: The average NPS score for new members is 6 (on a scale of -100 to 100), whereas the average score for established plan members is 25. This significant difference suggests that new members are not receiving clear information and support on how to navigate their healthcare benefits.
- Sicker patients less likely to receive proactive care coordination: Among patients with a self-reported health status of “poor/fair,” just 36% say their health plan helped them coordinate care. Among patients with a self-reported health status of “very good/excellent,” 43% say their health plan helped to coordinate care.
Highest Ranking Health Plans by State
The study measures customer satisfaction with commercial member health plans in 22 geographic regions. Highest-ranking health plans and scores are as follows:
- California: Kaiser Foundation Health Plan (749)
- Colorado: Kaiser Foundation Health Plan (716)
- Delaware/West Virginia/Washington D.C.: Highmark Blue Cross Blue Shield Delaware (725)
- East South Central: Aetna (760)
- Florida: Florida Blue (739)
- Heartland: Blue Cross and Blue Shield of Kansas City (743)
- Illinois/Indiana: Health Alliance Medical Plans (731)
- Maryland: Kaiser Foundation Health Plan (797)
- Massachusetts: Mass General Brigham Health Plan (formerly Allways) (711)
- Michigan: Health Alliance Plan of Michigan (735)
- Minnesota/Wisconsin: Quartz Health Plan (709)
- Mountain: UnitedHealthcare (721)
- New Jersey: Cigna (727)
- New York: Capital District Physicians Health Plan (773)
- Northeast: Anthem Blue Cross and Blue Shield Connecticut (730) and Blue Cross & Blue Shield of Rhode Island (730) in a tie
- Northwest: Aetna (723)
- Ohio: Anthem Blue Cross and Blue Shield Ohio (715)
- Pennsylvania: Geisinger Health Plan (732)
- South Atlantic: Kaiser Foundation Health Plan (785)
- Southwest: Aetna (720)
- Texas: UnitedHealthcare (729)
- Virginia: UnitedHealthcare (726)